Schistosomiasis transmission in Europe

Bisoffi, Zeno; Buonfrate, Dora; Beltrame, Anna

doi:10.1016/s1473-3099(16)30061-5

Cited by 11 publications

(6 citation statements)

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“…An unexpected outbreak of autochthonous urogenital schistosomiasis cases occurred in Corsica, France during the period 2013–2015 [ 37 , 38 ], caused by a parasite genetically related to S. haematobium from Senegal [ 39 , 40 ]. The outbreak raised attention to a possible spread of schistosomiasis in areas of Southern Europe [ 41 – 43 ] where the intermediate host is present [ 44 ]. Hence, surveillance on imported schistosomiasis in Europe, together with an increased professional awareness for this NTD, are necessary [ 45 ].…”

Section: Introductionmentioning

confidence: 99%

Schistosomiasis in immigrants, refugees and travellers in an Italian referral centre for tropical diseases

et al. 2018

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BackgroundSchistosomiasis is one of the most important neglected tropical diseases. If unrecognised and untreated, the chronic infection can lead to irreversible complications.MethodsRetrospective observational study aimed at describing clinical history, laboratory findings and imaging presentation of imported schistosomiasis diagnosed at the Centre for Tropical Diseases, Sacro Cuore Don Calabria Hospital of Negrar, Verona, Italy from 2010 to 2014. The aim of our study was to assess differences in demographic characteristics, clinical presentation, laboratory data and ultrasound findings between immigrants/visiting friends and relatives (VFR) from endemic countries (endemic group) and expatriates/travellers (non-endemic group).ResultsA total of 272 patients were retrieved: 234 in the endemic and 38 in the non-endemic group. Most of the patients acquired schistosomiasis in Africa (97.4%). Symptoms were reported by 52.9% of the patients; abdominal pain (36%), macroscopic hematuria (11.3%), and genito-urinary symptoms (7.4%) being the most frequently reported. Increased IgE and blood eosinophilia were observed in 169 (63.8%) and 130 (47.8%) patients, respectively. The proportion of positive serology was 250/272 (91.9%).The Circulating Cathodic Antigen CCA for Schistosoma mansoni was positive in 14/61 individuals (23%). At microscopy, infected subjects were 103/272 (37.9%). The species of Schistosoma found were S. haematobium (47.6%), S. mansoni (46.6%) or both (5.8%). Schistosomiasis was classified as confirmed in 103 (37.9%), probable in 165 (60.6%) and suspected in 4 (1.5%) cases using clinical presentation, laboratory data and ultrasound findings. The infection was further classified based on organ involvement: intestinal (17.9%), hepatosplenic (5.1%), urogenital (48.9%), and indeterminate (43.8%).The comparative analysis of endemic and non-endemic patients highlighted differences in sex and age. Endemic patients had more frequent ova identification (41.9% vs. 13.2%, P < 0.001) and increased IgE (70% vs. 26.3%, P < 0.001) when compared with non-endemic. Multivariate analyses showed that younger age, abnormal ultrasound findings and blood eosinophilia were significantly associated with positive microscopy (OR = 0.94, OR = 2.12, OR = 1.98, respectively).ConclusionsSymptoms, eosinophilia and abnormal ultrasound findings were present in about half of patients, without differences between groups. Many patients had positive serology but negative microscopy, indicating that schistosomiasis might be misdiagnosed. A combination of diagnostic tools may facilitate the diagnosis.Electronic supplementary materialThe online version of this article (10.1186/s40249-018-0440-5) contains supplementary material, which is available to authorized users.

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Section: Introductionmentioning

confidence: 99%

Schistosomiasis in immigrants, refugees and travellers in an Italian referral centre for tropical diseases

et al. 2018

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“…haematobium [8–12], and the availability of an effective and relatively inexpensive treatment [1,13,14], adequate protocols for screening and treatment of migrants are required. Further, the recent outbreak of urinary schistosomiasis in Corsica [15], originated by a West African strain [16,17], is a useful reminder that local transmission of schistosomiasis in Europe is still possible [18,19]. …”

Section: Introductionmentioning

confidence: 99%

Accuracy of parasitological and immunological tests for the screening of human schistosomiasis in immigrants and refugees from African countries: An approach with Latent Class Analysis

et al. 2017

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BackgroundSchistosomiasis is a neglected infection affecting millions of people, mostly living in sub-Saharan Africa. Morbidity and mortality due to chronic infection are relevant, although schistosomiasis is often clinically silent. Different diagnostic tests have been implemented in order to improve screening and diagnosis, that traditionally rely on parasitological tests with low sensitivity. Aim of this study was to evaluate the accuracy of different tests for the screening of schistosomiasis in African migrants, in a non endemic setting.Methodology/Principal findingsA retrospective study was conducted on 373 patients screened at the Centre for Tropical Diseases (CTD) in Negrar, Verona, Italy. Biological samples were tested with: stool/urine microscopy, Circulating Cathodic Antigen (CCA) dipstick test, ELISA, Western blot, immune-chromatographic test (ICT). Test accuracy and predictive values of the immunological tests were assessed primarily on the basis of the results of microscopy (primary reference standard): ICT and WB resulted the test with highest sensitivity (94% and 92%, respectively), with a high NPV (98%). CCA showed the highest specificity (93%), but low sensitivity (48%). The analysis was conducted also using a composite reference standard, CRS (patients classified as infected in case of positive microscopy and/or at least 2 concordant positive immunological tests) and Latent Class Analysis (LCA). The latter two models demonstrated excellent agreement (Cohen’s kappa: 0.92) for the classification of the results. In fact, they both confirmed ICT as the test with the highest sensitivity (96%) and NPV (97%), moreover PPV was reasonably good (78% and 72% according to CRS and LCA, respectively). ELISA resulted the most specific immunological test (over 99%). The ICT appears to be a suitable screening test, even when used alone.ConclusionsThe rapid test ICT was the most sensitive test, with the potential of being used as a single screening test for African migrants.

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“…Young Northern Senegalese visit France since decades for occupational opportunities in the gastronomic sector, e.g., the restaurant Sainte-Lucie de Porto Vecchio about 15 km from the bathing sites of the Cavu River, which does not constitute formal proof, but helps to better understand the likely parasitic spread. However, data available do not explain parasitic survival during less favorable winter months, and recurrence in subsequent years beyond 2014; a potential zoonotic role of livestock and/or rodents, the latter being capable of serving as hosts for Sb and ShxSb crossbreeds, but not Sh, as seen in the SRB and recent Beninese investigations is suspected [ 54 , 81 , 90 , 94 , 95 , 96 , 97 ]. Interestingly, Savassi and colleagues did confirm the presence of ShxSb hybrids in cattle and rodents ( Mastomys natalensis ) in addition to schoolchildren in Kessounou, Benin [ 97 , 98 ] in contrast to research performed in Senegal [ 45 ] and Cameroon [ 99 ].…”

Section: Schistosome Hybrids Across Africa—the Tip Of the Icebergmentioning

confidence: 99%

Natural Intra- and Interclade Human Hybrid Schistosomes in Africa with Considerations on Prevention through Vaccination

Panzner

Boissier

2021

Microorganisms

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Causal agents of schistosomiasis are dioecious, digenean schistosomes affecting mankind in 76 countries. Preventive measures are manifold but need to be complemented by vaccination for long-term protection; vaccine candidates in advanced pre-clinical/clinical stages include Sm14, Sm-TSP-2/Sm-TSP-2Al®, Smp80/SchistoShield®, and Sh28GST/Bilhvax®. Natural and anthropogenic changes impact on breaking species isolation barriers favoring introgressive hybridization, i.e., allelic exchange among gene pools of sympatric, interbreeding species leading to instant large genetic diversity. Phylogenetic distance matters, thus the less species differ phylogenetically the more likely they hybridize. PubMed and Embase databases were searched for publications limited to hybridale confirmation by mitochondrial cytochrome c oxidase (COX) and/or nuclear ribosomal internal transcribed spacer (ITS). Human schistosomal hybrids are predominantly reported from West Africa with clustering in the Senegal River Basin, and scattering to Europe, Central and Eastern Africa. Noteworthy is the dominance of Schistosoma haematobium interbreeding with human and veterinary species leading due to hybrid vigor to extinction and homogenization as seen for S. guineensis in Cameroon and S. haematobium in Niger, respectively. Heterosis seems to advantage S. haematobium/S. bovis interbreeds with dominant S. haematobium-ITS/S. bovis-COX1 profile to spread from West to East Africa and reoccur in France. S. haematobium/S. mansoni interactions seen among Senegalese and Côte d’Ivoirian children are unexpected due to their high phylogenetic distance. Detecting pure S. bovis and S. bovis/S. curassoni crosses capable of infecting humans observed in Corsica and Côte d’Ivoire, and Niger, respectively, is worrisome. Taken together, species hybridization urges control and preventive measures targeting human and veterinary sectors in line with the One-Health concept to be complemented by vaccination protecting against transmission, infection, and disease recurrence. Functional and structural diversity of naturally occurring human schistosomal hybrids may impact current vaccine candidates requiring further research including natural history studies in endemic areas targeted for clinical trials.

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Schistosomiasis transmission in Europe

Cited by 11 publications

References 9 publications

Schistosomiasis in immigrants, refugees and travellers in an Italian referral centre for tropical diseases

Schistosomiasis in immigrants, refugees and travellers in an Italian referral centre for tropical diseases

Accuracy of parasitological and immunological tests for the screening of human schistosomiasis in immigrants and refugees from African countries: An approach with Latent Class Analysis

Natural Intra- and Interclade Human Hybrid Schistosomes in Africa with Considerations on Prevention through Vaccination

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